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https://www.readbyqxmd.com/read/28735353/non-vitamin-k-oral-anticoagulants-noacs-and-their-reversal
#1
REVIEW
Sujan T Reddy, T C Cossey, Sean I Savitz, James C Grotta
PURPOSE OF REVIEW: An 80-year-old man presents with an acute right hemiparesis and National Institutes of Health Stroke Scale (NIHSS) of 25, 14 h after taking dabigatran. Activated partial thromboplastin time (aPTT) is 42.8 s. Arteriogram demonstrates left internal carotid artery thrombosis. What is the appropriate management of this patient with acute ischemic stroke while on a NOAC? RECENT FINDINGS: Idarucizumab is a reversal agent approved for dabigatran, and two more reversal agents, andexanet alfa and aripazine, are currently in development for NOACs...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28733757/the-clinico-radiological-spectrum-of-dyke-davidoff-masson-syndrome-in-adults
#2
Zeynep Özözen Ayas, Kıyasettin Asil, Ruhsen Öcal
Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, seizure, contralateral hemiplegia/hemiparesis, and mental retardation. In this study, clinical and radiological investigations of seven patients who were diagnosed with DDMS as adult age were evaluated and discussed. Seven patients (four male, three female) were included. The mean age ± SD of the patients was 46 ± 21 years. Clinical presentation of six patients was epileptic seizure. One patient was presented with head trauma due to a fall...
July 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28720529/population-rcharacteristics-and-progressive-disability-in-neuofibromatosis-type-2
#3
Kensho Iwatate, Takeshi Yokoo, Eriko Iwatate, Masahiro Ichikawa, Taku Sato, Masazumi Fujii, Jun Sakuma, Kiyoshi Saito
OBJECTIVE: To characterize the clinical features of the NF2 population and determine prognostic risk factors for progressive disabilities. METHODS: In this retrospective cohort study of the Japanese national NF2 registry between 2009-2013, various clinical data (demographic, history, oncological, and neurological) of 807 patients with diagnosis of NF2 were analyzed. The overall severity of neurological disability was assessed using a comprehensive 25-point scoring system encompassing a wide variety of neurological deficits...
July 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711177/size-of-facial-port-wine-birthmark-may-predict-neurologic-outcome-in-sturge-weber-syndrome
#4
Malgorzata Dymerska, Anna Y Kirkorian, Elizabeth A Offermann, Doris D Lin, Anne M Comi, Bernard A Cohen
OBJECTIVE: To determine whether the size of the birthmark in patients with Sturge-Weber syndrome (SWS) who have brain involvement can help predict neurologic disability. STUDY DESIGN: Fifty-one patients with SWS with facial birthmarks and brain involvement documented on magnetic resonance imaging were included in this retrospective chart review. A neuroradiologist, blinded to all clinical information, assigned a previously validated SWS neuroimaging score. A pediatric neurologist prospectively assigned previously validated neurologic severity scores, based on seizures, hemiparesis, visual field cut, and cognitive impairments...
July 12, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28688897/gross-motor-ability-predicts-response-to-upper-extremity-rehabilitation-in-chronic-stroke
#5
Sarah Hulbert George, Mohammad Hossein Rafiei, Alexandra Borstad, Hojjat Adeli, Lynne V Gauthier
The majority of rehabilitation research focuses on the comparative effectiveness of different interventions in groups of patients, while much less is currently known regarding individual factors that predict response to rehabilitation. In a recent article, authors presented a prognostic model to identify the sensorimotor characteristics predictive of the extent of motor recovery after Constraint-Induced Movement (CI) therapy amongst individuals with chronic mild-to-moderate motor deficit using the enhanced probabilistic neural network (EPNN)...
July 5, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28687151/control-of-lateral-weight-transfer-is-associated-with-walking-speed-in-individuals-post-stroke
#6
HaoYuan Hsiao, Vicki L Gray, Robert A Creath, Stuart A Binder-Macleod, Mark W Rogers
Restoring functional gait speed is an important goal for rehabilitation post-stroke. During walking, transferring of one's body weight between the limbs and maintaining balance stability are necessary for independent functional gait. Although it is documented that individuals post-stroke commonly have difficulties with performing weight transfer onto their paretic limbs, it remains to be determined if these deficits contributed to slower walking speeds. The primary purpose of this study was to compare the weight transfer characteristics between slow and fast post-stroke ambulators...
June 23, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28686121/surgical-and-molecular-considerations-in-the-treatment-of-pediatric-thalamopeduncular-tumors
#7
Ryan P Lee, Kimberly A Foster, Jock C Lillard, Paul Klimo, David W Ellison, Brent Orr, Frederick A Boop
OBJECTIVE Thalamopeduncular tumors are a group of pediatric low-grade gliomas that arise at the interface of the thalamus and brainstem peduncle. They typically occur within the first 2 decades of life, presenting with progressive spastic hemiparesis. Treatment strategies, including surgical intervention, have varied significantly. The authors present their experience in the treatment of 13 children, ages 2-15 years, with non-neurofibromatosis-related pilocytic astrocytomas located in the thalamopeduncular region...
July 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28680736/cortical-aneurysms-of-the-middle-cerebral-artery-a-review-of-the-literature
#8
Alessandro Ricci, Hambra Di Vitantonio, Danilo De Paulis, Mattia Del Maestro, Soheila Dehcordi Raysi, Domenico Murrone, Sabino Luzzi, Renato Juan Galzio
BACKGROUND: Middle cerebral artery (MCA) aneurysms constitute from 18-40% of all intracranial aneurysms. They are mainly found in the proximal and bifurcation tracts and only in the 1.1-1.7% of cases they are located in the distal segment. The authors report a case of a ruptured saccular cortical MCA aneurysm with unknown etiology. CASE DESCRIPTION: A 53-year-old female was admitted with a sudden severe headache, nausea, vomiting, and a slight left hemiparesis. The computed tomography (CT) scan showed subarachnoid hemorrhage (SAH) in the left sylvian fissure and intracerebral hemorrhage (ICH) in the left posterior parietal area...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28678212/functional-recovery-differences-after-stroke-rehabilitation-in-patients-with-uni-or-bilateral-hemiparesis
#9
Saad M Bindawas, Hussam M Mawajdeh, Vishal S Vennu, Hisham M Alhaidary
OBJECTIVE: To examine the functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis. METHODS: In this retrospective study, we included data from the medical record of all 383 patients with uni- or bilateral hemiparesis after stroke who were admitted to King Fahad Medical City-Rehabilitation Hospital between 2008 and 2014 in Riyadh, Kingdom of Saudi Arabia. According to the site of hemiparesis, we classified patients into 3 groups: right hemiparesis (n=208), left hemiparesis (n=157), and bilateral hemipareses (n=18)...
July 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28674731/tractography-guides-the-approach-for-resection-of-thalamopeduncular-tumors
#10
Ryan Foley, Frederick Boop
BACKGROUND: Thalamopeduncular tumors arise at the junction of the inferior thalamus and cerebral peduncle, and present with a common clinical syndrome of progressive spastic hemiparesis. METHOD: Formal preoperative magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were performed. Postoperative MRI was obtained to evaluate the extent of tumor resection. A prospective analysis of clinical outcomes was then conducted by the senior author. CONCLUSIONS: Preoperative tractography is a useful adjunct to surgical planning in tumors that displace motor pathways...
July 3, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28674364/diffuse-cerebral-vasoconstriction-in-a-intravascular-lymphoma-patient-with-a-high-serum-mpo-anca-level
#11
Atsuhiko Sugiyama, Makoto Kobayashi, Ayaka Daizo, Miyako Suzuki, Hirotoshi Kawashima, Shin-Ichiro Kagami, Hiroaki Tanaka, Yoshio Suzuki, Takashi Matsunaga, Satoshi Kuwabara
An 87-year-old woman presented with a 3-month history of fever, edema of the lower legs, and gait disturbance. A laboratory examination revealed high serum levels of myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA). Although microscopic polyangiitis was initially suspected and treated, the patient subsequently developed transient hemiparesis and disturbed consciousness. Brain magnetic resonance imaging/angiography revealed infarct-like lesions, pachymeningeal involvement, and diffuse cerebral vasoconstriction...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28669652/severe-vasospasm-of-the-middle-cerebral-artery-after-mechanical-thrombectomy-due-to-infective-endocarditis-an-autopsy-case
#12
Wataru Nishino, Yosuke Tajima, Toru Inoue, Michihiro Hayasaka, Bi Katsu, Koichi Ebihara, Daisuke Kawauchi, Masaaki Kubota, Sumio Suda
Untreated infective endocarditis (IE) often produces infective emboli in major cerebral arteries. We describe a case of middle cerebral artery occlusion due to IE, which caused severe vasospasm and reocclusion after mechanical thrombectomy (MT). We present the pathologic findings of the occluded middle cerebral artery and investigate the precautions to be taken while performing MT due to IE. A 72-year-old man with atrial fibrillation treated with dabigatran presented with right hemiparesis and aphasia. A diffusion-weighted image showed a high-intensity area in the left temporoparietal junction, and magnetic resonance angiography revealed a left M2 occlusion...
June 29, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28669269/microsurgical-management-of-a-high-grade-brain-arteriovenous-malformation-in-the-central-lobe-after-unsuccessful-radiosurgery
#13
Jean G de Oliveira, Carlos R Massella, Carlos Vanderlei M de Holanda, Miguel Giudicissi-Filho, Luis A B Borba
The recommendation for the great majority of high-grade brain arteriovenous malformations (bAVMs) is observation, except for those patients with recurrent hemorrhages, progressive neurological deficits, steal-related symptoms, or AVM-related aneurysms, for whom intervention should be considered. These are general recommendations, and the decision should be made on an individual basis. Surgical resection of an AVM in the central lobe may cause postoperative sensorimotor deficits since this anatomical region includes the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669250/primary-cns-nonamyloidogenic-light-chain-deposition-disease-case-report-and-brief-review
#14
Juan Jose Mercado, James M Markert, William Meador, Philip Chapman, Arie Perry, James R Hackney
The true incidence of light chain deposition disease (LCDD) restricted to the central nervous system (CNS) is unknown. To our knowledge only 7 cases of LCDD restricted to the brain have been previously reported. We herein describe an unusual example. A 44-year-old man presented with a history of ischemic retinopathy in 2004 and left lower extremity hypoesthesia in 2007 that progressed gradually to left-sided weakness and numbness in the 2 years prior to his hospitalization in 2015. A stereotactic brain biopsy was performed, displaying nonspecific hyaline deposits of amorphous "amyloid-like" material involving deep brain white matter and vessels...
June 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28664022/intracerebral-hemorrhage-caused-by-cerebral-hyperperfusion-after-superficial-temporal-artery-to-middle-cerebral-artery-bypass-for-atherosclerotic-occlusive-cerebrovascular-disease
#15
Fumihiro Matano, Yasuo Murai, Takayuki Mizunari, Koji Adachi, Shiro Kobayashi, Akio Morita
Few papers have reported detailed accounts of intracerebral hemorrhage caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery bypass (STA-MCA) bypass for atherosclerotic occlusive cerebrovascular disease. We report a case of vasogenic edema and subsequent intracerebral hemorrhage caused by the cerebral hyperperfusion syndrome (CHS) after STA-MCA bypass for atherosclerotic occlusive cerebrovascular disease disease without intense postoperative blood pressure control. A 63-year-old man with repeating left hemiparesis underwent magnetic resonance angiography (MRA), which revealed right internal carotid artery (ICA) occlusion...
January 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28664017/coexistence-of-quasi-moyamoya-disease-and-poems-syndrome-in-a-patient-with-intracranial-hemorrhage-a-case-report-and-literature-review
#16
Izumi Yamaguchi, Junichiro Satomi, Nobuaki Yamamoto, Shotaro Yoshioka, Yoshiteru Tada, Kenji Yagi, Yasuhisa Kanematsu, Shinji Nagahiro
POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome is a rare paraneoplastic syndrome elicited by plasma cell dyscrasia. Its clinical manifestations are multiple and stroke is not a recognized feature. A 44-year-old woman with a 3-month history of bilateral lower extremity sensorimotor disturbance was admitted to our hospital. Examinations revealed polyneuropathy, organomegaly, hypothyroidism, monoclonal gammopathy, pelvic plasmacytoma, and elevated serum vascular endothelial growth factor (VEGF) levels...
January 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28664012/cerebral-infarction-arising-from-takotsubo-cardiomyopathy-case-report-and-literature-review
#17
Yoshihiro Otani, Koji Tokunaga, Satoshi Kawauchi, Satoshi Inoue, Kyoichi Watanabe, Hideki Kiriyama, Kosuke Sakane, Kiyoaki Maekawa, Isao Date, Kengo Matsumoto
Although most patients with takotsubo cardiomyopathy have a favorable outcome, complications are not uncommon. Recent studies have reported an increase in incidence of cardioembolic complications; however, the association between takotsubo cardiomyopathy and stroke, in particular thromboembolic cerebral infarction, remains unclear. We reported a 44-year-old woman who had a cerebral infarction resulting from takotsubo cardiomyopathy. She had felt chest discomfort a few days prior to infarction, and later developed left hemiparesis...
October 2016: NMC Case Rep J
https://www.readbyqxmd.com/read/28659855/upper-extremity-motor-impairments-and-microstructural-changes-in-bulbospinal-pathways-in-chronic-hemiparetic-stroke
#18
Meriel Owen, Carson Ingo, Julius P A Dewald
Following hemiparetic stroke, precise, individuated control of single joints is often replaced by highly stereotyped patterns of multi-joint movement, or abnormal limb synergies, which can negatively impact functional use of the paretic arm. One hypothesis for the expression of these synergies is an increased dependence on bulbospinal pathways such as the rubrospinal (RubST) tract and especially the reticulospinal (RetST) tracts, which co-activate multiple muscles of the shoulder, elbow, wrist, and fingers...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28659187/tuberculous-meningoencephalitis-associated-with-brain-tuberculomas-during-pregnancy-a-case-report
#19
Sadie Namani, Shemsedin Dreshaj, Arieta Zogaj Berisha
BACKGROUND: Tuberculous meningitis is globally highly prevalent and is commoner in resource-limited countries and in patients with immunosuppression. Central nervous system tuberculosis is one of the severest forms of extrapulmonary tuberculosis during pregnancy and associated brain tuberculomas have been rarely reported. With the availability of neuroimaging at our hospital center, we present the first case of tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy...
June 29, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28649477/the-importance-of-catheter-angiography-in-computed-tomography-angiography-negative-subarachnoid-hemorrhage
#20
Ali S Haider, Caleb Gottlich, Anadjeet Khahera, Steven Vayalumkal, Umair Khan, Eliel N Arrey, Jacob Campbell, Richa Thakur, Sam Finn, Kennith F Layton
Computed tomography angiography (CTA) has become an effective tool in the evaluation of patients with subarachnoid hemorrhage (SAH), but it still has limitations. Up to 15% of non-traumatic SAH cases are negative on CTA. The benefits of catheter angiography in the evaluation of certain cases of CTA-negative SAH have been previously demonstrated. Here, we present the case of a 48-year-old female who presented with headache and right-sided hemiparesis, who later became apneic and required intubation. A computed tomography (CT) scan of the head demonstrated a diffuse SAH...
May 17, 2017: Curēus
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